Miller, D.K., Chibnall, J.T., Videen, S.D., & Duckro, P.N. (2005). Supportive-affective group experience for persons with life-threatening illness: Reducing spiritual, psychological, and death-related distress in dying patients. Journal of Palliative Medicine, 8, 333–343.

DOI Link

Intervention Characteristics/Basic Study Process

The intervention was a 75-minute supportive-affective group that met monthly offering Life-Threatening Illness Supportive-Affective Group Experience (LTI-SAGE). These groups were for education and support, not group therapy. Topics included

  • Group dynamics and expectations
  • Recognizing and asserting needs
  • Feelings and emotions
  • Symptom control
  • Living well while ill
  • Intimate relationships
  • Spiritual needs
  • Asking for help
  • End-of-life care planning/decision making
  • Legacy
  • Hope
  • Group closure.

Groups consisted of three to eight patients, with one or two group facilitators.

Two measurements were taken: baseline and 12 months

In the intervention group (n = 37), group assignment was based on diagnosis and race.

In the control group (n = 32), patients received quarterly mailings of existing, readily available self-help resource materials, with a phone call to ensure that mailings were received.

Sample Characteristics

The study reported on a sample of 69 African American and Caucasian patients with any serious medical condition severe enough to create a limited life expectancy (not cause death within six months).

Study Design

The study was a randomized pre/post-test trial with a longitudinal design.

Measurement Instruments/Methods

  • Beck Depression Inventory
  • State-Trait Anxiety Inventory (STAI)
  • Death Distress Scale
  • Spiritual Well-Being Scale
  • Illness Disability Index
  • Perceived Social Support Inventory
  • Analysis of covariance
  • Statistics done in two ways: intent-to-treat basis (with the seven noncompliant patients) and also with the seven noncompliant patients removed from the intervention group

Results

  • In the intervention group, 7 patients attended 3/12 groups and 21 patients attended 9/12 groups.
  • There were no significant statistical differences between groups in anxiety levels. The intervention group did enjoy reduced depression, increased spiritual well-being, and reduced death-related feelings of meaninglessness; p level set at 0.10.
  • STAI stats: t(40) = 0.8 with p value 0.40 at baseline
  • SSAI postintervention: p = 0.70

Limitations

  • The study had a small sample size.
  • Not all patients were diagnosed with cancer.
  • The intervention required specially trained facilitators to teach groups.